The rice LATE ELONGATED HYPOCOTYL enhances salt tolerance by regulating Na+/K+ homeostasis and ABA signalling.

The circadian clock plays multiple functions in the regulation of plant growth, development and response to various abiotic stress. Here, we showed that the core oscillator component late elongated hypocotyl (LHY) was involved in rice response to salt stress. The mutations of OsLHY gene led to reduced salt tolerance in rice. Transcriptomic analyses revealed that the OsLHY gene regulates the expression of genes related to ion homeostasis and the abscisic acid (ABA) signalling pathway, including genes encoded High-affinity K+ transporters (OsHKTs) and the stress-activated protein kinases (OsSAPKs). We demonstrated that OsLHY directly binds the promoters of OsHKT1;1, OsHKT1;4 and OsSAPK9 to regulate their expression. Moreover, the ossapk9 mutants exhibited salt tolerance under salt stress. Taken together, our findings revealed that OsLHY integrates ion homeostasis and the ABA pathway to regulate salt tolerance in rice, providing insights into our understanding of how the circadian clock controls rice response to salt stress.

Light and gas dual-function detection and mutual enhancement based on hyperdoped black silicon.

We introduce a unique dual-function detector with an asymmetric light illumination based on the black silicon co-hyperdoped with sulfur and nitrogen for light and gas detection, and the properties in NO2 gas sensing and photoelectric detection are studied under various light and gas environments, respectively. Enhanced performance of the device under certain light and gas conditions is observed. When illuminated at the optimal wavelength, the gas sensors' responsivity to NO2 can be enhanced by approximately 5 to 200 times over 730 nm illumination, respectively. The photodetectors' photoresponsivity increases 15 to 200 times in a 300 ppm NO2 gas environment compared to air. Such mutual enhancement achieved through the clever combination of light and gas implies a novel approach to improve the performance of the black silicon detectors in both gas sensing and photoelectric detection.

Evaluation of postoperative complications of hypospadias using high-frequency ultrasound imaging.

PURPOSE: Various complications following hypospadias surgery present distinct manifestations when examined with ultrasound. Utilizing high-frequency ultrasound, clinicians can promptly identify these complications and initiate appropriate treatment. The aim of this study is to catalogue the ultrasonographic presentations of various postoperative complications following hypospadias surgery, thereby providing a reference for ultrasonographic diagnosis. METHODS: Ultrasonic images of post-hypospadias surgery from October 1, 2015, to June 30, 2023, recorded at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences, serve as the basis for this investigation. Drawing on patient clinical diagnoses, this study compiles and selects representative ultrasound images of diverse complications. RESULTS: The study encompassed a total of 121 subjects; 26 demonstrated urethral stricture on ultrasonic images, two presented local urethral dilation, six showed intraurethral hair-like structures, 17 revealed intraurethral septum, two exhibited intraurethral fold, one had urethral calculus, one displayed urethral calcification, 12 indicated intraurethral urine accumulation, and two showed urethral diverticulum. CONCLUSION: Ultrasound examination is helpful for postoperative diagnosis following hypospadias, detecting complications such as urethral stricture, urethral hair growth, and urethral diverticulum, which can help doctors choose appropriate clinical treatment strategies.

Development of a major amputation prediction model and nomogram in patients with diabetic foot.

BACKGROUND: Diabetes mellitus, as one of the world's fastest-growing diseases, is a chronic metabolic disease that has now become a public health problem worldwide. The purpose of this research was to develop a predictive nomogram model to demonstrate the risk of major amputation in patients with diabetic foot. METHODS: A total of 634 Type 2 Diabetes Mellitus (T2DM) patients with diabetic foot ulcer hospitalized at the Air Force Medical Center between January 2018 and December 2023 were included in our retrospective study. There were 468 males (73.82%) and 166 females (26.18%) with an average age of 61.64 ± 11.27 years and average body mass index of 24.45 ± 3.56 kg/m2. The predictive factors were evaluated by single factor logistic regression and multiple logistic regression and the predictive nomogram was established with these features. Receiver operating characteristic (subject working characteristic curve) and their area under the curve, calibration curve, and decision curve analysis of this major amputation nomogram were assessed. Model validation was performed by the internal validation set, and the receiver operating characteristic curve, calibration curve, and decision curve analysis were used to further evaluate the nomogram model performance and clinical usefulness. RESULTS: Predictors contained in this predictive model included body mass index, ulcer sites, hemoglobin, neutrophil-to-lymphocyte ratio, blood uric acid (BUA), and ejection fraction. Good discrimination with a C-index of 0.957 (95% CI, 0.931-0.983) in the training group and a C-index of 0.987 (95% CI, 0.969-1.000) in the validation cohort were showed with this predictive model. Good calibration were displayed. The decision curve analysis showed that using the nomogram prediction model in the training cohort and validation cohort would respectively have clinical benefits. CONCLUSION: This new nomogram incorporating body mass index, ulcer sites, hemoglobin, neutrophil-to-lymphocyte ratio, BUA, and ejection fraction has good accuracy and good predictive value for predicting the risk of major amputation in patients with diabetic foot.

Modeling defensive resource allocation in multilayered systems under probabilistic and strategic risks.

Confronting the continuing risk of an attack, security systems have adopted target-hardening strategies through the allocation of security measures. Most previous work on defensive resource allocation considers the security system as a monolithic architecture. However, systems such as schools are typically characterized by multiple layers, where each layer is interconnected to help prevent single points of failure. In this paper, we study the defensive resource allocation problem in a multilayered system. We develop two new resource allocation models accounting for probabilistic and strategic risks, and provide analytical solutions and illustrative examples. We use real data for school shootings to illustrate the performance of the models, where the optimal investment strategies and sensitivity analysis are presented. We show that the defender would invest more in defending outer layers over inner layers in the face of probabilistic risks. While countering strategic risks, the defender would split resources in each layer to make the attacker feel indifferent between any individual layer. This paper provides new insights on resource allocation in layered systems to better enhance the overall security of the system.

A data-driven and cost-oriented FMEA-MCDM approach to risk assessment and ranking in a fuzzy environment: A hydraulic pump factory case study.

In today's highly competitive business environment, firms strive to maximize profitability by minimizing or eliminating disruptions and failures to maintain a competitive edge. This study focuses on evaluating risks in a hydraulic pump factory as a means to achieve sustainable growth. To accomplish this, a team of experts was formed to identify potential errors, utilizing a combination of risk priority number criteria weighted by Fuzzy Shannon's entropy and a fusion of multi-criteria decision-making and failure mode and effects analysis for evaluating and ranking failures. Moreover, the study emphasizes the importance of considering the interaction among risk assessment indicators, the inclusion of cost of failure, and modeling under fuzzy uncertainty circumstances, as they have a notable impact on the final ranking of failures to be processed for risk mitigation action planning. This research brings a new dimension to enhance the overall effectiveness of risk assessment by aggregation, as evidenced by a novel use of data classification in machine learning and correlation in statistics. The findings indicate that the aggregated ranking data series is best matched and most influenced by the weighted aggregated sum product assessment method, with the highest rate of recall and precision accomplished.

Atelectasis After Bilateral Costal Cartilage Ear Reconstruction.

This study, through the case analysis of 2 patients with congenital bilateral microtia, explores the causes and preventive strategies of atelectasis after bilateral rib cartilage extraction surgery. Although ear reconstruction technology is quite mature, it may lead to complications, such as atelectasis, due to thoracic surgery and general anesthesia. Pediatric patients are more prone to such complications due to narrower airways, less pulmonary surfactant, and difficulties in pain management. Therefore, for children undergoing bilateral rib cartilage extraction surgery, health care providers need to closely monitor their respiratory status, effectively manage postoperative pain, and encourage them to engage in deep breathing and coughing exercises as much as possible to prevent and improve atelectasis.

Successful Treatment Without Using Dantrolene Sodium on a Child Occurring Malignant Hyperthermia During Induction of General Anesthesia: A Case Report.

Malignant hyperthermia (MH) is a fatal hyperthermia with a high mortality, which usually occurs during induction of general anesthesia. Dantrolene sodium is a wonder drug currently used for treating malignant hyperthermia. However, preparing, storing, and maintaining dantrolene sodium are crucially expensive, thus making it financially unsatisfactory and difficult for clinicians to acquire in time. Monitoring patients' condition closely and intervening promptly when early signs of malignant hyperthermia occur can effectively prevent the condition from worsening and win over time for the arrival of dantraline sodium. This article is to report a case in which we successfully rescued a child occurring malignant hyperthermia without using dantrolene sodium.

Application of System Nursing in the Prevention of Postoperative Nonstructural Scoliosis in Patients With Ear Reconstruction.

OBJECTIVE: To evaluate whether early systematic nursing can reduce the occurrence of postoperative nonstructural scoliosis in patients undergoing ear reconstruction. METHODS: A total of 136 patients with congenital microtia who underwent ear reconstruction surgery at the Department of Plastic Surgery, Chinese Academy of Medical Sciences from, January 2022 to July 2022 were included as study subjects. They were randomly divided into a routine nursing group and a systematic nursing group. After preoperative and postoperative education, as well as continuous follow-up intervention after surgery, spinal CT three-dimensional imaging examination was performed 6 months later to measure the Cobb angle and observe the occurrence of spinal scoliosis. RESULTS: Compared with the routine nursing group, the incidence and severity of postoperative nonstructural scoliosis were significantly reduced in patients who received systematic nursing. CONCLUSIONS: Systematic nursing intervention for patients undergoing ear reconstruction can help prevent the occurrence of postoperative nonstructural scoliosis and has a positive effect on improving patient prognosis. It is worth promoting in clinical treatment.

A Method of Tumescent Anesthesia Based on Facial and Cervical Nerve Block for Face and Neck Liposuction.

OBJECTIVE: Liposuction of the face and neck is a common treatment for fat deposition. If conventional methods are used for tumescent anesthesia, patients will experience pain, affecting their surgery experience. Using general anesthesia for liposuction of the face and neck can increase the cost to the patient and cause various adverse effects. METHODS: The authors selected appropriate parts of the patient's neck, angle of the mandible, and face as needle entry points, and performed nerve block in different directions. Afterward, we performed facial liposuction on these patients and evaluated their level of pain. RESULTS: This study included a total of 20 female participants who underwent facial liposuction after a nerve block. The Visual Analog Scale score of the 20 participants was 0.55 (±0.60). There were no significant adverse reactions during the treatment process, and all patients expressed satisfaction with this treatment. CONCLUSIONS: In this article, the authors present a method of tumescent anesthesia based on facial and cervical nerve block that significantly reduces the pain associated with facial and neck liposuction, eliminating the need for general anesthesia and enhancing the patient's comfort during the procedure.

What Factors Can Affect the Occurrence of Vertigo in Patients After Craniofacial Surgery in China?

Vertigo is a complication of craniomaxillofacial contour plastic surgery characterized by dizziness from hypovolemia in the cerebral hemispheres and brainstem. The authors analyzed the current status and influencing factors of postoperative vertigo in patients who undergo craniomaxillofacial contouring and discussed improvements in nursing strategies. The authors investigated 418 patients admitted to the authors' hospital who underwent craniomaxillofacial contouring between November 2020 and October 2023 and divided them into asymptomatic and symptomatic groups based on syncopal precursors or vertigo. The authors screened the current status of vertigo in patients after craniomaxillofacial contouring and the factors affecting vertigo and determined nursing improvement strategies. After craniomaxillofacial contouring, 125 patients had vertigo symptoms. Postcraniomaxillofacial contouring syncope or vertigo was associated with age, patient vertigo history, family history, depression, weight loss, blood pressure at admission, feeding before getting out of bed, and the level of intraoperative hemorrhage Multifactorial logistic regression analysis revealed the association between postcraniomaxillofacial contouring syncope or vertigo and vertigo history, depression, weight loss, feeding before getting out of bed, and intraoperative bleeding volume. Vertigo precursor incidence after craniomaxillofacial contouring surgery is 29.90%. Its influencing factors are complex, suggesting that nurses need to improve the perioperative health education of craniomaxillofacial contouring surgery and optimize the nursing care, encourage patients to have a reasonable diet or provide parenteral nutritional support preoperatively, help patients get out of bed early postoperatively, encourage them to have multiple meals in little quantity before getting out of bed, and control the intraoperative bleeding, to ensure patient safety postoperatively.

Trigeminal Neuralgia after Hyaluronic Acid and Botox Injection.

A rare case of trigeminal neuralgia following injections of Hyaluronic Acid and Botox was documented. In addressing the severe pain and swelling caused by the injection, a novel combination therapy was employed, notably including 5-fluorouracil. The significant improvement observed in this case not only provided clinical insights but also spurred further investigation into the underlying mechanisms linking trigeminal nerve damage to local dermal filler injections. The aim was to glean new medical perspectives and develop practical preventive strategies to mitigate such complications in future cases. This approach highlights the importance of understanding and addressing the potential neurological impacts of cosmetic procedures. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .

Factors Influencing Bone Resorption after Augmentation Mentoplasty with Implants: A Retrospective Study Using Three-Dimensional Imaging.

BACKGROUND: Augmentation mentoplasty with implants is an extremely rewarding procedure. Bone resorption is almost unavoidable. The high-risk factors for chin bone resorption have not been explored in the past. This study aimed to analyze and evaluate the factors influencing bone resorption after augmentation mentoplasty with implants using three-dimensional imaging. METHODS: We retrospectively analyzed preoperative craniofacial Computed Tomography scan data from 105 patients who underwent mandibular implantation surgery and 108 patients who did not. We also examined the extent to which different factors influenced the occurrence of bone resorption in the chin area. RESULTS: Patients with silicone gel implants are more prone to bone resorption than those with Medpor implants. Patients who experienced bone resorption had thicker mentalis muscles than those who did not experience bone resorption (6.35 ± 1. mm vs. 5.73 ± 1.25 mm, P < 0.05), and thinner cortical bone (3.25 ± 1.65 mm vs. 5.22 ± 2.04 mm, P < 0.05). Additionally, implants placed above the mandibular bone were more likely to induce bone resorption than those placed below it. CONCLUSIONS: This study is the first to systematically reveal the impact of implant type, placement position, mentalis muscle thickness, and cortical bone thickness on bone resorption after chin augmentation surgery. For patients with thicker mentalis muscles and thinner cortical bones, greater attention should be paid to the occurrence of bone resorption. Choosing silicone implants or placing the implants higher on the mandible can help reduce the occurrence of bone resorption. This study can assist clinicians in selecting appropriate treatment methods, thereby reducing post-implantation bone resorption. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266.

Application of High-Frequency Ultrasound to Evaluate Forehead Filling Materials.

BACKGROUND: In recent years, soft tissue materials have been applied as forehead fillers. Some filling materials need to be removed or refilled in a timely manner in certain situations; therefore, it is important to develop a method to identify the location and type of filling materials. This study summarizes the imaging findings of different filling materials under high-frequency ultrasound, providing a reference for clinical treatment. METHODS: We screened facial ultrasound images performed at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from April 2015 to July 2023 and classified and summarized the types of frontal filling materials and their imaging results. RESULTS: This study included ultrasound imaging results from 114 patients, including 39 with hyaluronic acid (HA) filling, 45 with polyacrylamide hydrogel (PAG) filling, 14 who received autologous fat transplantation, 2 who received prosthesis implantation, 2 who received both HA and PAG filling, and 12 who received silicone oil filling. HA mainly manifests as an anechoic zone on ultrasonography, with images divisible into four types. PAG primarily presents as fine punctate echoes, divisible into five types. Fat transplantation presents as a low-echo area with uneven density, divisible into five types. Finally, the silicone oil-filling material appears as a cloud-like high echo on the forehead, visible throughout the entire skin layer, and unclear imaging in deep tissues. CONCLUSION: High-frequency ultrasound is a safe and reliable method to evaluate the type and position of forehead filling materials, which can be easily applied in clinical practice. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Comprehensive Multi-drug Strategy for the Management of Foreign Body Granuloma Following Mesotherapy.

BACKGROUND: Mesotherapy is a medical technique that administers cosmetic nutrients directly to the dermis through microdrop injections for aesthetic purposes. Its application has become increasingly widespread. However, there have also been a growing number of reported cases of multiple foreign body granulomas following mesotherapy. It is crucial to find an effective and safe treatment. METHODS: In this study, 31 patients with facial foreign body granuloma after mesotherapy were included. A mixture of 5-fluorouracil, lidocaine injection , and normal saline was prepared in a ratio of 1:1:4 and injected subcutaneously. Triamcinolone acetonide, 5-fluorouracil, lidocaine injection, and normal saline were prepared in a ratio of 2:5:3:10. Subcutaneous injections were administered to each papule using a 34G needle. The treatments were scheduled at intervals of 10-14 days. Color Doppler ultrasound was used to evaluate the condition before the initial treatment and after the final treatment. RESULTS: The preoperative ultrasonography revealed diffuse hypoechoic areas in the dermis of the facial skin. After an average of 2-4 treatment sessions, a significant improvement was observed in all patients' appearance, with reduced redness and swelling, softened nodules, absence of pain and itching symptoms, and no evident abnormal echo on ultrasound examination. During a follow-up period ranging from 1 to 8 months, no recurrence or adverse reactions were reported. CONCLUSION: This technique demonstrates clear efficacy. And this formulation effectively reduces the dosage of triamcinolone acetonide and minimizes the risk of adverse reactions such as skin atrophy. Therefore, it can be considered an effective treatment for multiple foreign body granulomas following mesotherapy. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Localization of the Submandibular Glands Using High-Frequency Ultrasound.

BACKGROUND: Injecting botulinum toxin (BTX) into the submandibular glands (SMGs) can treat drooling symptoms in neurological diseases and improve the aesthetics of SMG hypertrophy and ptotic SMGs. OBJECTIVES: This study aimed to define the size and position of the SMGs by high-frequency ultrasound, and to perform statistical analysis to improve the safety and accuracy of BTX injection therapy. METHODS: Neck ultrasonography with high-frequency ultrasound was performed on 214 volunteers. The length, height, and thickness of the SMGs, and the distance between the SMGs and the midline, the anterior border of the sternocleidomastoid, the mandible, and the surface were measured. RESULTS: The SMGs were almond-shaped with a mean [standard deviation] length of 33.7 [4.7] mm, a thickness of 13.3 [2.9] mm, and a height of 27.6 [6.0] mm. The length and height were significantly different between underage and youth groups. The size of the SMGs did not show any notable differences with increasing BMI; however, their depth, and the distance from the mandible, midline, and anterior border of the sternocleidomastoid increased. No significant differences were observed between the affected and healthy sides in patients with microtia, hemifacial microsomia, or cleft lip and palate. CONCLUSIONS: Ultrasound provides more comprehensive information regarding the size and position of the SMGs, which can serve as a reference in BTX therapy and in the diagnosis of SMG diseases involving size alterations.

Botulinum Toxin Injection Technique for Reducing the Masseter Size and Enhancing the Jawline.

BACKGROUND: The injection of botulinum toxin into the masseter muscle is an important method for improving hypertrophy. However, some patients may experience adverse reactions, such as sagging of the lower jaw. Therefore, we proposed a method of injecting botulinum toxin into the masseter and platysma muscles that would reduce masseter size and enhance the jawline. OBJECTIVES: The aim of this study was to reduce the masseter size while enhancing the jawline. METHODS: Twenty patients received botulinum toxin injections into the masseter and platysma muscles. Pain levels were evaluated with the visual analog scale. All patients were photographed before and 6 months after treatment. Evaluations were performed based on standardized criteria. The lift index, reduction index, and symmetry index were performed to assess the degree of jawline elevation, masseter size reduction, and jawline symmetry before and after treatment. RESULTS: The mean visual analog scale score of the 20 patients was 2.80 (±1.24). The mean lift index score decreased from 4.93 (±0.34) to 4.53 (±0.37), P < .05. The mean reduction index score decreased from 3.13 (±0.27) to 2.74 (±0.27), P < .05. The mean symmetry index score changed from 0.0393 (±0.0296) to 0.0257 (±0.0246), P < .05. CONCLUSIONS: Botulinum toxin injections into the masseter and platysma muscles through nerve block reduced the masseter size, elevated the jawline, and improved symmetry.

On the adoption of nonpharmaceutical interventions during the pandemic: An evolutionary game model.

The adoption of behavioral nonpharmaceutical interventions (NPIs) among the public is essential for tackling the COVID-19 pandemic, yet presents challenges due to the complexity of human behaviors. A large body of literature has utilized classic game theory to investigate the population's decisions regarding the adoption of interventions, where the static solution concept such as the Nash equilibrium is studied. However, individual adoption behavior is not static, instead it is a dynamic process that involves the strategic interactions with other counterparts over time. The study of quantitatively analyzing the dynamics on precautionary behavior during an outbreak is rather scarce. This article fills the research gap by developing an evolutionary game-theoretic framework to model the dynamics of population behavior on the adoption of NPI. We construct the two-group asymmetric game, where behavioral change for each group is characterized by replicator equations. Sensitivity analyses are performed to examine the long-term stability of equilibrium points with respect to perturbation of model parameters. We found that the limiting behavior of intervention adoption in the population consists of only pure strategies in a game setting, indicating that the evolutionary outcome is that everyone either takes up the preventive measure or not. We also applied the framework to examine the mask-wearing behavior, and validated with actual data. Overall, this article provides insights into population dynamics on the adoption of intervention strategy during the outbreak, which can be beneficial for policy makers to better understand the evolutionary trajectory of population behavior.

Counterterrorism resource allocation during a pandemic: The effects of dynamic target valuations when facing a strategic terrorist.

The outbreak of pandemics such as COVID-19 can result in cascading effects for global systemic risk. To combat an ongoing pandemic, governmental resources are largely allocated toward supporting the health of the public and economy. This shift in attention can lead to security vulnerabilities which are exploited by terrorists. In view of this, counterterrorism during a pandemic is of critical interest to the safety and well-being of the global society. Most notably, the population flows among potential targets are likely to change in conjunction with the trend of the health crisis, which leads to fluctuations in target valuations. In this situation, a new challenge for the defender is to optimally allocate his/her resources among targets that have changing valuations, where his/her intention is to minimize the expected losses from potential terrorist attacks. In order to deal with this challenge, in this paper, we first develop a defender-attacker game in sequential form, where the target valuations can change as a result of the pandemic. Then we analyze the effects of a pandemic on counterterrorism resource allocation from the perspective of dynamic target valuations. Finally, we provide some examples to display the theoretical results, and present a case study to illustrate the usability of our proposed model during a pandemic.

A machine learning-based generalized approach for predicting unauthorized immigration flow considering dynamic border security nexus.

Unauthorized immigration has been a long-standing and contentious challenge for developed and developing countries. Numerous continually evolving push and pull factors across international borders, such as economy, employment, population density, unrest, corruption, and climate have driven this migration. Large-scale pandemics such as COVID-19, causing further instability in countries' financial well-being, can initiate or alter emigration flow from different countries. In light of such a complex confluence of factors, climate change, and demographic shifts in migrant communities, it is high time to shift toward machine learning-reinforced generalized approaches from the traditional parametric approaches based on migrant community-specific localized surveys. To our best knowledge, no literature has explored the nonparametric approach and developed a comprehensive database independent of localized surveys to analyze unauthorized migration. This article fills this gap by deploying nine nonparametric machine learning algorithms for predicting unauthorized immigration flow considering the dynamic border security nexus. This framework considers the Seasonal Autoregressive Integrated Moving Average model as the null model. The proposed novel framework removes the dependency on localized survey-based studies and provides a more cost-effective, faster, and big data-friendly approach. This study finds the Bayesian Additive Regression Tree model as the best predictive model.